There are more than one million medical institutions nationwide, with 3.867 million practicing doctors
The level of medical care has been significantly improved, and the safety system has become more and more stringent.
On September 24, medical staff from Zhili Town Health Center in Wuxing District, Huzhou City, Zhejiang Province taught children in North Kindergarten the correct hand-washing procedures.
Photo by Xinhua News Agency reporter Xu Yu
Opening words: General Secretary Xi Jinping pointed out that people’s health is the foundation of social civilization and progress, an important symbol of national prosperity and national prosperity, and the common pursuit of the broad masses of people.
It is necessary to take the overall situation, take a long-term view, focus on the old problems and new challenges we are facing, and come up with practical measures to promote the construction of a healthy China in an all-round way.
Without the health of the whole people, there will be no comprehensive well-off.
During the 14th Five-Year Plan period, my country will enter a new stage of development. Accelerating the improvement of the quality of health and health supply and service levels is a requirement to adapt to the changes in the main contradictions of our society and meet the needs of the people for a better life. The foundation for fair, more sustainable and safer development.
On this occasion, it is necessary to summarize and count the changes and achievements of the health industry since the 13th Five-Year Plan, as well as the people's sense of health gains.
Therefore, this edition launches a series of reports on "Towards the Health of the People in the Past Five Years" for readers.
Medical quality and medical safety are directly related to the health of the people.
In the past five years, China’s medical technology capabilities and medical quality have been significantly improved, and it has continued to build a high-quality and efficient medical and health service system to better meet the health needs of the people, laying a solid foundation for the implementation of the Healthy China strategy.
The "2019 National Medical Service and Medical Quality and Safety Report" recently released by the National Health Commission shows that the accessibility and safety of medical services in China continue to improve.
Weak majors such as pediatrics and obstetrics
Significantly increased strength
During the 13th Five-Year Plan period, the national health undertakings achieved remarkable results.
According to Guo Yanhong, inspector of the Medical Administration and Hospital Administration of the National Health Commission, the first is the continuous increase in the supply of medical resources.
In terms of institutions, the total number of medical institutions nationwide in 2019 has exceeded 1 million, of which the number of hospitals is 34,000; the number of consultations in medical institutions nationwide is 8.7 billion, an increase of 14.7% over 2014; the number of inpatient consultations has reached 270 million, compared with 2014 An increase of 30.4%.
At the level of some specialties, the strength of weak specialties such as pediatrics and obstetrics has increased significantly.
In 2019, the number of beds per 1,000 children’s hospitals was 2.2, an increase of 0.17 from 2015.
The utilization rate of obstetric beds in tertiary public general hospitals dropped from 98.2% in 2016 to 83.7% in 2018, so the shortage of obstetric beds has eased.
In the field of critical care, the proportion of beds in intensive care medicine in hospitals rose from 1.9% in 2014 to 2.2% in 2018, an increase of 16.4%.
In terms of human resources, 3.867 million licensed (assistant) physicians nationwide in 2019, an increase of 33.7% over 2014; the total number of registered nurses nationwide reached 4.45 million in 2019, an increase of nearly 50% over 2014.
Secondly, medical service capabilities and medical service efficiency have been continuously improved.
From 2016 to 2018, the number of DRGs groups reflecting the breadth of medical services increased from 535 groups to 563 groups in tertiary hospitals across the country; the case mix index reflecting medical service capabilities increased from 0.95 to 0.97 for tertiary hospitals.
At the same time, the average length of stay in tertiary hospitals in 2019 was 9.2 days, a decrease of 1.5 days from 2014, achieving a five-year consecutive decline.
Third, the level of medical quality and safety continues to improve.
In 2018, the total mortality of inpatients in tertiary public general hospitals was 0.60%, and the total mortality in second-level public general hospitals was 0.47%. Both of these indicators achieved three consecutive years of decline.
Fourth, the level of rational drug use continues to improve.
Take antibacterial drugs as an example. From 2011 to 2018, the use rate of antibacterial drugs in hospitalized patients dropped from 61.4% to 40.4%; the intensity of antibacterial drug use dropped from 61.8DDD to 43.7DDD.
Aiming at "insufficiency" and "imbalance"
Focus on the problem
According to Guo Yanhong, the main problems existing in health care are, first of all, the insufficient development of medical resources that has not been completely resolved.
The number of doctors and nurses per 1,000 population is still low, and the number of beds in tertiary public hospitals is still tight.
Infectious diseases and psychiatric professionals are relatively scarce.
Secondly, the problem of unbalanced distribution of medical resources still exists.
From the perspective of patients' medical treatment in different places, the top five provinces with the highest patient outflow rate were Tibet, Anhui, Inner Mongolia, Hebei, and Gansu, and the top five provinces with patients inflow were Shanghai, Beijing, Jiangsu, Zhejiang and Guangdong.
The provinces where the outflow of patients go for medical treatment are basically concentrated in the central and western regions, while the inflow provinces are basically concentrated in the eastern region.
The third is that there are still weak links in medical quality and safety, especially grassroots hospitals and private hospitals that still need to be improved.
Because of the large number of medical institutions in China, there is still a gap in the level of medical quality and safety. The level of medical quality and safety in some regions, institutions, and specialties needs to be further improved.
Guo Yanhong said that the next step is to be problem-oriented, speed up the expansion of high-quality medical resources, continue to expand the supply of high-quality medical resources, and focus on solving the problems of development, focusing on common and frequently-occurring diseases that seriously endanger people’s health and the need to prevent major public health risks. The problem of “adequacy”; speed up the rational distribution of medical resources between regions, take patients' medical treatment in different places and promote the homogenization of hospitals as the starting point, focus on strengthening the capacity building of the central and western regions and the grassroots, and promote the sinking of high-quality medical resources to solve them The problem of "imbalance"; strengthen medical quality and safety management, further improve the quality control system, expand the scope of quality control work, and improve the scientific, refined, and informatized level of quality control work.
Use of medical technology
Weave a tight system network
With the continuous improvement of China's medical service level, the difficulty and variety of medical technology are also increasing. How to strengthen medical technology access management and ensure the quality and safety of medical technology has become the focus of social attention.
"Medical technology is an important carrier of medical services. The management of medical technology is directly related to medical quality and medical safety. The clinical application of new medical technologies and the promotion of appropriate technologies are not only important for improving the level of medical technology, but also for patients. The quality and safety of medical care have also played a positive role in promoting.” Guo Yanhong said, “But medical technology is a double-edged sword. While bringing well-being to patients, non-standard application or even abuse will directly affect patients’ health. Health will also threaten the quality and safety of medical care."
In this regard, the National Health Commission has promulgated and implemented the "Administrative Measures for the Clinical Application of Medical Technology" from the regulatory level in the past few years, standardizing and strengthening medical institutions, health administrative departments, quality control organizations and corresponding industry groups to promote management and Regarding the responsibilities of everyone in medical technology, a series of systems have been established in the management of medical technology.
The first system is the classified management system of medical technology.
For the clinical safety and effectiveness of inaccurate, there are major ethical issues, clinically eliminated, and the technology that has not been verified by clinical research is listed as prohibited technology.
As for technologies that are technically difficult, risky, and use scarce clinical resources, they are classified as restricted technologies.
The second system is to establish a filing system for restricted technologies.
For the 15 national-level restricted technologies that have been included in the list, clinical application and management practices have been formulated.
Medical institutions that want to implement this type of technology must conduct an evaluation against the clinical application specifications of these clinical technologies. Those who are qualified for the evaluation must file with the health administration department.
The third system is to establish a quality control system for medical technology.
For key medical technologies, there are technical specifications, technical quality control evaluation indicators, and quality control management through various professional quality control centers. Through the overall evaluation, evaluation, monitoring, and feedback of the implementation of such technologies, medical technology is guaranteed At the same time of quality, continuous improvement.
The fourth system is to implement a standardized training system for the clinical application of medical technology.
Medical staff who implement key medical technologies must undergo standardized training to ensure the quality and safety of clinical technology applications.
The fifth system is the information disclosure system.
"We require health administrative departments at or above the county level to promptly disclose to the public the list of medical institutions that can carry out restricted medical technologies after filing and related information." Guo Yanhong said.
Xiong Jian